What is the first-line drug for rescuing patients with anaphylactic shock?
Aug 09, 2021
Source: Cainiu Health
Dr. Wang Liming
Introduction
In anaphylactic shock, epinephrine 0.5 mg should be administered immediately via subcutaneous or intravenous injection. Glucocorticoids, antihistamines, rapid fluid resuscitation, and supplemental oxygen are critical components of initial management. If cardiac arrest occurs, the dose of epinephrine should be increased, and cardiopulmonary resuscitation (CPR) initiated. Early endotracheal intubation or tracheostomy is essential to relieve upper airway obstruction.
Anaphylactic shock is characterized by an IgE-mediated hypersensitivity reaction, often involving multi-organ injury. Clinically, it frequently occurs during drug administration and is marked by the sudden onset of chills, high fever, and other symptoms that are disproportionate to the fever.
Upon recognition of anaphylactic shock, the offending drug infusion must be immediately discontinued, and epinephrine 0.5 mg should be administered subcutaneously or intravenously. Prompt initiation of glucocorticoids, antihistamines, rapid fluid resuscitation, and supplemental oxygen constitutes critical first-line therapy.
If cardiac arrest occurs secondary to anaphylaxis, epinephrine dosing should be rapidly escalated, and cardiopulmonary resuscitation (CPR) must be initiated without delay. For patients presenting with hoarseness, oropharyngeal, lingual, or laryngeal edema, early endotracheal intubation or tracheostomy is recommended to relieve upper airway obstruction and ensure airway patency.
